| Doctor Name: | MR. CHRISTOPHER COFFIN OLD |
| NPI Number: | 1306977392 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | EDS, LPC, NCC, MFT |
| License Number: | 0701003891 |
| Business Practice Address: | 17400 Northwoods Blvd Building A, Suite 1 Truckee, CA - 961616062 |
| Business Phone Number: | 5305824171 |
| Business Fax Number: | 5305501810 |
| Mailing Address: | 17400 Northwoods Blvd, Building A, Suite 1 TRUCKEE |
| State: | CA |
| Postal Code: | 961616062 |
| Phone Number: | 5305824171 |
| Fax Number: | 5305501810 |
| NPI Enumeration Date: | 03/08/2007 |
| NPI Last Update Date: | 07/30/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 0701003891 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |